Syphilis is a highly contagious disease that can be fatal if left untreated. It is transmitted by vaginal intercourse, anal intercourse, kissing, and oral-genital contact. Syphilis has several phases, and symptoms will vary according to the phase of the disease. Symptoms may include small painless sores called chancres on the genitals, vagina, cervix, lips, mouth, or anus; headaches; muscle pains in the arms or legs; hair loss; loss of appetite; nausea; constipation; fever; and rashes. In most cases, however, no symptoms will be exhibited. During the primary phase, chancres will appear anywhere from three weeks to ninety days after exposure. The sores last from three to five weeks and ooze a clear, highly infectious liquid. During the secondary phase, symptoms commonly include rashes on the palms of the hands and the soles of the feet that appear within two weeks to six months after exposure. The rashes usually last about four weeks. Syphilis also has latent phases during which there are no symptoms. During the first four years of the disease, a person is generally not contagious, but a fetus can be infected by its mother at this time, which can result in stillbirths or birth defects. In its final phase, syphilis causes serious damage to the nervous system, heart, brain, and other organs. If left untreated, death can result. For more information on syphilis, please contact your health care provider.